,,ii #aahth ,,congress #ast ,session ,s4 #agfi ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ca 7legislative day1 ,may #cj71 #bjbc ,mr4 ,carper 7for himself and ,mr4 ,sullivan7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to establish a demonstration project testing ,whole ,child ,health ,models1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,kickstarting ,innovative ,demonstrations ,supporting ,kids ,health ,act of #bjbc or the ,,kids ,health ,act of #bjbc4 #b4 ,establishment of whole child health models ,section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is amended by adding at the end the following new subsection3 7cc7 ,whole child health demonstration project 7#a7 ,in general ,the ,secretary1 acting through the ,deputy ,administrator and ,director of the ,center for ,medicaid and ,,chip ,services1 shall conduct a demonstration project 7referred to in this subsection as the demonstration project7 under which participating ,states shall design and implement whole child health models in #a or more target communities in accordance with the requirements of this subsection4 ,the requirements of section #aijb7;a77#a7 7relating to statewideness7 shall not apply to the demonstration project4 7#b7 ,design phase 7,a7 ,grants ,not later than #ab months after the date of the enactment of this subsection1 the ,secretary shall award up to #ae grants to ,states that submit complete applications for such grants which meet the requirements of subparagraph 7,c74 7,b7 ,selection of grantees ,in awarding grants under this paragraph1 the ,secretary shall1 to the extent possible1 prioritize awarding grants to a geographically diverse selection of ,states and target communities of different sizes and with varying experience with value-based payment1 including rural and urban communities4 7,c7 ,grant application ,a ,state shall include in an application for a grant awarded under this paragraph the following3 7i7 ,a description of each proposed target community in which the ,state proposes to implement a whole child health model4 7ii7 ,for each target community described in clause 7i71 a statement of the proposed objectives of the ,state in implementing a whole child health model in that community4 7iii7 ,such other information as the ,secretary may require4 7,d7 ,use of grant funds 7i7 ,in general ,a ,state awarded a grant under this paragraph shall use the grant funds to-- 7,i7 conduct or use an existing needs assessment that is not more than two years old and meets the requirements of clause 7ii7 for each proposed target community2 7,,ii7 not later than #ab months after being awarded the grant1 design and submit for approval by the ,secretary a proposed whole child health model that meets the requirements of subparagraph 7,e7 for each target community based on the results of the needs assessment and other assessments or surveys conducted for that community2 and 7,,iii7 implement the whole child health model during the implementation phase described in paragraph 7#c74 7ii7 ,needs assessment requirements ,a needs assessment conducted for a proposed target community with grant funds awarded to a ,state shall include the following3 7,i7 ,an evaluation of the physical health1 mental1 emotional and behavioral health1 developmental1 social1 relational and substance use disorder service needs of eligible individuals in the target community1 including needs that could be addressed through population-based or community-based interventions4 7,,ii7 ,a review of the resources available to meet the physical health1 mental health1 and substance use disorder service needs of eligible individuals in the target community4 7,,iii7 ,a description of the barriers identified in the target community to eligible individuals accessing resources and services to address their physical health1 mental health1 and substance use disorder service needs4 7,,iv7 ,a description of health disparities identified in the target community1 including input from community residents in the target community4 7,e7 ,whole child health model requirements 7i7 ,in general ,a proposed whole child health model shall include descriptions of the following3 7,i7 ,how the ,state and its multi-sector partners will address the physical health1 mental1 emotional and behavioral health1 developmental1 social1 relational and substance use disorder service needs of eligible individuals in the target community identified in the needs assessment of that community through implementation of the whole child health model and provision of whole child health services4 7,,ii7 ,how the ,state ,medicaid1 human services1 and child welfare agencies will coordinate with community partners to ensure the successful implementation of the whole child health model in the target communities and the provision of whole child health services4 7,,iii7 ,the lead agency or other entity the ,state proposes to designate to coordinate activities carried out to implement the whole child health model in the target communities4 7ii7 ,requirements ,a proposed whole child health model shall meet the following requirements3 7,i7 ,align with an existing or planned delivery and payment system of the ,state plan under this title or under a waiver of such plan1 including1 as applicable1 a managed care delivery system4 7,,ii7 ,include partnerships with child and family serving organizations and agencies such as health care providers1 payers1 school districts1 public health and child care4 7,,iii7 ,promote the delivery of trauma-informed and culturally competent care1 including strategies to address systemic resource needs1 including workforce shortages1 in the target community and an assessment of the potential impact of the model on health equity1 disparities1 and safety net providers in the target community4 7,,iv7 ,coordinate funding sources under the ,state plan under this title 7or under a waiver of plan71 the ,state plans under parts ,b and ,e of title ,,iv1 and other applicable funding sources1 for the whole child health services provided under the model4 7,v7 ,include-- 7aa7 the design and implementation or adaptation of a value-based payment arrangement for providing whole child health services under the ,state plan under this title 7or under a waiver of such plan7 that promotes pediatric health2 or 7bb7 in the case of a ,state that faces significant barriers to implementing or adapting such a value-based payment arrangement1 a proposal for steps that the ,state will take towards advancing value-based care with respect to whole child health services provided under the ,state plan under this title 7or under a waiver of such plan74 7,,vi7 ,include strategies to coordinate referrals to whole child health services1 including using telehealth1 referral networks and_/or other technologies to facilitate access to whole child health services4 7,,vii7 ,include strategies to promote the integration of primary care with whole child health services and substance use disorder services4 7,,viii7 ,include strategies to integrate and streamline eligibility1 enrollment1 and renewal processes to facilitate enrollment in health coverage and other benefit programs4 7,,ix7 ,include strategies to promote school-based health and wellness4 7,x7 ,describe how the ,state will leverage or enhance existing health information technology infrastructure and cross-sector data-sharing capabilities to support the provision of enhanced care coordination services1 including with respect to claiming administrative matching funds for the design1 development1 and installation of data systems to allow or enhance coordination among ,state agencies and other entities4 7,,xi7 ,describe how the ,state will evaluate the impact of the model on child health and disparities in health outcomes1 according to requirements outlined by the ,secretary4 7,,xii7 ,include other such population health strategies or core services as the ,state determines appropriate4 7iii7 ,participation by ,indian tribes in whole child health models ,the ,secretary may waive or otherwise modify the requirements for a whole child health model described in clause 7ii7 to the extent necessary to permit ,indian tribes to participate in such a model4 7#c7 ,implementation phase ,after the design period1 the implementation phase of the demonstration project shall be conducted for a period of not less than #dh months and not more than #gb months4 7#d7 ,authorization of appropriations 7,a7 ,in general ,there are authorized to be appropriated to the ,secretary for the purpose of carrying out this subsection1 out of any funds in the ,treasury not otherwise appropriated1 #abe1jjj1jjj1 to remain available until expended4 7,b7 ,limitation on use of funds ,from any amounts appropriated pursuant to this paragraph1 the ,secretary shall use-- 7i7 not more than #b1jjj1jjj for administrative costs1 staffing1 and reporting requirements2 7ii7 not more than #aj1jjj1jjj for learning platforms1 staffing1 and technical assistance related directly to the design and implementation of whole child health models1 and to carry out activities under this subsection2 and 7iii7 not more than #c1jjj1jjjj may be used for carrying out evaluations described in paragraph 7#e74 7,c7 ,payment for whole child health services 7i7 ,in general ,for each fiscal quarter occurring during the implementation phase of the demonstration project1 subject to clause 7ii71 the ,secretary shall pay each ,state selected to participate in that phase of the project1 an amount equal to #hj percent of the amounts expended by the ,state during such quarter for providing whole child health services to eligible individuals in the target communities net of any ,federal payments made to the ,state for such expenditures1 under this title or otherwise4 7ii7 ,requirement ,the additional ,federal funds paid to a ,state under this subparagraph shall be used to supplement1 not supplant1 the level of ,state funds expended for services that are treated as whole child health services under the demonstration project4 7#e7 ,reports and evaluation 7,a7 ,in general ,a ,state that is selected to participate in the demonstration project shall report on the outcomes under the entity's whole child health model pursuant to periodic reporting requirements established by the ,secretary4 7,b7 ,state reports ,each ,state awarded a grant under this subsection shall submit the following reports to the ,secretary3 7i7 ,interim report ,an interim report at the end of the first #bd months of the implementation phase of the project that describes-- 7,i7 the progress of the ,state's implementation of the whole child health model in the target communities2 7,,ii7 the organizations and providers that are participating in the implementation of the model in the target communities2 7,,iii7 the number of eligible individuals in the target communities receiving enhanced care coordination services2 and 7,,iv7 such other information as the ,secretary may require4 7ii7 ,final report ,a final report not later than #a year after the end of the implementation phase of the demonstration project that describes-- 7,i7 best practices and challenges in implementing the whole child health model in the target communities2 7,,ii7 the impact of the model on child well-being1 health care outcomes and health disparities in the target communities2 and 7,,iii7 such other information as the ,secretary may require4 7,c7 ,,gao report ,not later than #c years after the first grant is awarded under this subsection1 the ,comptroller ,general of the ,united ,states shall submit a report to ,congress evaluating the individual1 financial1 and systems-level impacts associated with whole child health models implemented under the demonstration project4 7#f7 ,consultation ,a ,state awarded a grant under paragraph 7#b7 shall consult with stakeholders1 such as eligible individuals and their primary caregivers1 schools1 health care1 mental health1 and substance use disorder treatment organizations1 pediatric providers1 public health departments1 child care providers1 juvenile justice programs1 child welfare programs1 and community-based organizations1 in designing and carrying out the activities required under paragraph 7#b71 and with respect to the implementation and evaluation of the whole child health models implemented by the ,state4 ,such consultation may include establishment of a ,community ,advisory ,board as defined by the ,secretary4 7#g7 ,responsibilities of the secretary 7,a7 ,technical assistance 7i7 ,in general ,the ,secretary shall provide ,states awarded a grant under paragraph 7#b7 with technical assistance with respect to the design of whole child health models4 ,such assistance may include assisting ,states with moving along a whole child health model and utilizing innovative financing strategies1 such as braiding public and private funds4 ,as feasible1 the ,secretary may partner with other ,federal agencies1 including the ,office of ,management and ,budget1 when providing technical assistance to promote a whole child health approach4 ,the ,secretary shall also provide such ,states with technical assistance with respect to implementation of such models4 7ii7 ,shared learning ,the ,secretary shall facilitate shared learning1 such as a learning collaborative1 among the ,states participating in the demonstration project4 7iii7 ,reports to congress ,the ,secretary shall submit to the ,committee on ,finance of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives the following reports3 7,i7 ,design phase ,not later than #cf months after the date on which design grant funds are first awarded under paragraph 7#b71 a report that describes the whole child health models proposed by ,states4 7,,ii7 ,implementation phase 7aa7 ,interim report ,not later than #c years after the date on which the implementation phase of the demonstration project begins1 an interim report4 7bb7 ,final report ,not later than #b years after the date on which the demonstration project ends1 a final report4 7cc7 ,content ,the interim and final reports required under this clause shall include the following3 7,,aa7 ,a summary of the whole child health models being implemented under the demonstration project4 7,,bb7 ,an assessment of the impacts of such models on the physical and mental health and well-being of eligible individuals in the target communities4 7,,cc7 ,a description of the most effective strategies of such models in promoting the physical and mental health of eligible individuals1 including the effectiveness of such strategies in reducing health disparities and improving health equity4 7,,dd7 ,a summary of the information reported to the ,secretary by ,states4 7dd7 ,legislative recommendations ,in addition to the information required under item 7cc71 the final report submitted under item 7bb7 shall include recommendations for such ,federal legislative changes1 if any1 as the ,secretary recommends to implement positive outcomes identified by the use of whole child health models under the demonstration project4 7#h7 ,definitions ,in this subsection3 7,a7 ,eligible individual ,the term eligible individual means an individual who has not attained age #ba and who is eligible for medical assistance under a ,state plan under this title or under a waiver of such plan1 or for assistance under a ,state child health plan under title ,,xxi or under a waiver of such plan4 7,b7 ,indian tribe ,the term ,indian ,tribe has the meaning given that term in section #d7;e7 of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd7;e774 7,c7 ,target community ,the term target community means1 with respect to a ,state1 the boundaries of a geographic area within the ,state in which the ,state proposes to implement a whole child health model4 7,d7 ,whole child health services ,the term whole child health services means the following3 7i7 ,comprehensive care management4 7ii7 ,enhanced care coordination services and referrals to health1 developmental and social supports that include strategies to-- 7,i7 identify and address the physical1 mental1 emotional1 and behavioral health1 developmental1 relational and social needs of eligible individuals2 7,,ii7 coordinate referrals1 as needed1 to health care1 mental1 emotional1 and behavioral health1 substance use disorder treatment1 child development1 and social service providers2 7,,iii7 ensure that eligible individuals follow up with service providers to whom they are referred2 and 7,,iv7 facilitate the ability of eligible individuals to access needed services by centralizing1 coordinating with1 or co-locating resources4 7#i7 ,requirement to issue guidance on combining ,federal and non-,federal funds to address social drivers of health in low-income populations ,not later than #cfe days after the selection of eligible entities under this subsection1 the ,secretary shall issue and disseminate guidance and technical assistance to grant awardees to clarify strategies and best practices to combine funds1 including ,medicaid1 in the context of a child health and wellness fund1 consistent with ,federal law1 and shall make such guidance publicly available4 4